Job Description

Welcome to Suburban Gastroenterology Ltd (SGI)! SGI is a thriving single specialty medical practice with an attached state-of-the-art ambulatory surgical center located in the heart of Naperville, IL. We are a team of dedicated physicians and advance practice providers focused on treating gastrointestinal illness, colon cancer screening, liver disease and obesity. We provide a supportive and collaborative work environment with room for professional growth.

Overview
We are looking for a dedicated Prior Authorization Specialist to join our team. The Prior Authorization Specialist plays a critical role in obtaining prior authorization from multiple insurance companies before services are rendered for advanced GI procedures for patients.

This position requires a detail-oriented individual who can navigate complex insurance processes while adhering to regulatory guidelines. Prioritizing incoming prior authorization task in order of importance. Meeting turnaround times for authorization guidelines. Collaborating with departments to ensure all medical documentation is received prior to submitting authorization as well as CPT coding information. Initiates and completes appeals process for denied services. Documenting authorization and progression of authorizations. The ideal candidate will possess strong organizational skills and a solid understanding of medical terminology and coding practices.

Duties

• Review and process prior authorization requests for medical services, procedures, and medications.
• Communicate with healthcare providers, patients, and insurance companies to obtain necessary information for authorization.
• Verify patient eligibility and benefits through insurance verification processes.
• Maintain accurate records of all prior authorization requests and outcomes in compliance with HIPAA regulations.
• Collaborate with managed care organizations to ensure timely approvals and resolve any issues related to authorizations.
• Utilize medical coding knowledge, including ICD-9 codes, to accurately document diagnoses and procedures.
• Stay updated on changes in insurance policies, regulations, and medical terminology relevant to prior authorizations.

Skills

• Proficiency in office operations within a medical office environment.
• Experience with medical records management and documentation practices.
• Strong understanding of insurance verification processes and managed care principles.
• Familiarity with medical coding systems, particularly ICD-9 coding.
• Knowledge of HIPAA regulations to ensure patient confidentiality and compliance.
• Excellent communication skills for effective interaction with healthcare professionals, patients, and insurers.
• Detail-oriented mindset with strong organizational abilities to manage multiple requests efficiently.

Join our team as a Prior Authorization Specialist and contribute to our mission of delivering exceptional healthcare services. If you are passionate about making a difference in the healthcare industry and possess the required skills, we invite you to apply today to be part of our dedicated team. Please email cover letter and resume to HR@suburbangi.com

Job Type: Full-time

Pay: $20.00 - $22.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Disability insurance
• Employee assistance program
• Employee discount
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Work Location: In person

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